1. Northern Region Colorectal Cancer Audit (NORCCAG) Colorectal NSSG – Audit meeting 1 st April 2006 – 31 st July 2010 Dorothy Simms – Audit Co-ordinator Friday 6 th May, 2010

2. 3.1 million approx 1700 cases/annum Prospective Audit 1997 – Ongoing ‘Population’ based

3. Process Extracted from NBOCAP(8012 records) Removed duplicate treatments(7020 records) Supplemented by Research Fellows and clinicians Validation Analysis

4. Appendix 0.30% Caecum 14.40% Ascending 9.10% Hepatic 3.16% Transverse 5.43% Splenic 2.48% Descending 3.29% Sigmoid 22.76% Rectosigmoid 8.42% Rectum 30.66% Appendix21 Caecum1011 Ascending639 Hepatic222 Transverse381 Splenic174 Descending231 Sigmoid1598 Rectosigmoid591 Rectum2152 Site of Tumour n=7020

5. Demographics n=7020 Age: Median = 71 (17 -102) Sex: Male 3991 (56.85%) Female 3029 (43.15%)

6. Denominator n=7020 No Procedure n=1571 (22.4%)* *no evidence of surgical procedures although a small number had a pathology recorded Procedures n=5449* *5130 (73.0% of 7020) had a resective procedure  4655 (85.4%) are known to have a resection  160 (2.9%) underwent local excisions  131 (2.4%) patients only had stomas formed  161(3.0%) had their tumours stented  315 (5.8%) recorded as having other procedures

7. Operative Procedures (n=5449) ResectionsLocal Excisions Right Hemi1302 (23.9%)TEMS 31 (0.6%) Ext Rt Hemi 382 (7.0%)Per Anal Excision 14 (0.3%) Transverse Col 18 (0.3%) Polypectomy 115 (2.1%) Left Hemi 470 (8.6%) Sigmoid Col 283 (5.2%)Other procedures Ant Res 1444 (26.5%)Palliative 319 (5.9%) Total Col 100 (1.9%)Other 315 (5.8%) Hartmanns 220 (4.0%) APER 353 (6.5%) Panproctocolectomy 83 (1.5%)

8. Rectal cancers n=2152 No procedure recorded: n=584 (27.1%) => Denominator = 1568 Resections: n=1252 (79.8%) APER 342 (21.8%) Lt Hemicolectomy 4 (0.3%) Ant Res 784 (50.0%) Sigmoid colectomy 4 (0.3%) Hartmanns 95 (6.1%) Total colectomy 8 (0.6%) Panproctocolectomy 15 (1.0%) Local Excisions: n=84 (5.4%) TEMS 30 (2.0%) Per anal excision 13 (0.8%) Polypectomy 41 (2.6%) Other Procedures: n=232 (14.8%) 83 stomas, 25 stents, 2 Dx Invxs, 1 EUA, 7 open and close, 114 other

9. Grade of Operating Surgeon by Cancer Unit

10. ASA classification by Cancer Unit

11. Surgical Access – 1 st April 2006 to 31 st July 2007

12. Surgical Access – 1 st August 2007 to 31 st July 2008

13. Surgical Access – 1 st August 2008 to 31 st July 2009

14. Surgical Access – 1 st August 2009 to 31 st July 2010

15. Urgency of Operation by Cancer Unit

16. Dukes Stage by Cancer Unit 1153 patients were recorded as having stage ‘D’ disease

17. Stage ‘D’ disease by Cancer Unit

18. Lymph Node Yield

19. Role of NORCCAG Publication and dissemination of results  Regional presentations 6 th May 2011  Written Report 27 th May 2011  Local presentations June – October 2011  Corrected/validated data regional presentation TSSG

20. The future of NORCCAG To be discussed………..